“Learn what to do and not to do,” said Nassif, adding America’s quest to fight aging sparks greater interest in cosmetic surgery. And, with celebrities openly admitting to a “little nip and tuck,” any stigma with giving Mother Nature a little help has been removed. Then there’s the social media craze, putting pressure on people to look perfect.

Measuring the risk

With the upswing in plastic surgery—15.6 million cosmetics procedures and 5.8 million reconstructions where performed last year—comes bigger risks. Many physicians, looking to tap into the market for profitable cash procedures, have branched into cosmetic surgery even if not qualified to do so. And Americans looking to save money continue to pursue medical tourism with mixed results.

“People don’t realize plastic surgery is as dangerous as any surgery. Anyone can call themselves a plastic surgeon after a weekend course and legally start doing breast augmentation,” warned Dubrow.

What’s their advice to avoid a botched surgery? Do your research, be realistic about the recovery and don’t expect surgery to change your life, Dubrow explained. “Go in with eyes wide-open,” he added. “Make sure [the doctors] are American Board of Plastic Surgery certified with years of experience.”

“We aren’t saving lives, but we are changing lives and that can be life saving.”

Visit the physician’s facility, added Nassif. “Read reviews, look at before and after photos and make sure there are no red flags. Select a physician who specializes in what you are doing,” suggested Nassif, a renowned facial plastic and reconstructive expert.

Among the most popular procedures in the U.S. are rhinoplasties, breast augmentations, face lifts and tummy tucks. Surgery isn’t just relegated to women anymore with men showing their vanity side. There is a surge in buttocks implants, traced to the “Kardashian” influence. As far as trends, Dubrow is encouraged by more women asking for natural-sized breasts—C cups instead of the Triple L he saw on an episode of Botched.

Both physicians are enthused about the impact technology has on non-invasive procedures, such as the use of more lasers, a greater role for Botox, micro-needling and PRP (platelet rich plasma) facials, as a few examples.

Chasing perfection

“Some chasing perfection take it too far,” warned Dubrow, adding surgery needs to be done for the right reasons. Nassif even orders psychological review for candidates before any procedure. The doctors frequently refuse patients they feel are cosmetic surgery addicts or who suffer from body dysmorphic disorder.

There are, however, physicians willing to perform risky surgery (there were more than 5,000 applications for “Botched” in its second season). The most common that go awry include noses, breasts, liposuction and tummy tucks. Dubrow, the show’s “body guy,” has seen everything from lopsided breasts to abdominal mishaps that destroy belly buttons. New surgeries, such as the “Brazilian Butt,” run higher risks of disastrous results because doctors haven’t amassed experience.

“A lot of people who have botched surgeries feel like a monster and don’t want to leave the house,” said Nassif, who conceived the idea for reality show at dinner with executives from the Real Housewives television franchise (both have appeared on the reality series) as an avenue to help to the worst cases, including those ravaged by cancer treatments.

The doctors said helping people enriches their lives, too. Seeing a patient cry for joy after seeing a successful cosmetic revision was “the greatest feeling in the world,” said Nassif. That sentiment was echoed by Dubrow. “We aren’t saving lives, but we are changing lives and that can be life saving.”